Prolapse of ureteroceles through the urethra appearing as vulval swelling is relatively uncommon presentation in girls. Therefore, we present in this video a newborn girl who had prolapsing ureterocele appearing as vulval swelling that was managed by endoscopic decompression.

This video demonstrates a case of 6-day old girl who was presented with vulval swelling that was initially misdiagnosed as a case of an imperforate hymen. Pelvic ultrasonography showed midline pelvic cystic structure, measuring (1.5x0.8 cm), ? urinary bladder vs. ureterocele with an empty bladder. She underwent voiding cystourethrogram which revealed right GV vesicoureteral reflux, filling defect of the prolapsing ureterocele and dilated urethra proximal to the ureterocele. Under anesthesia, the swelling was reduced into the bladder, but it prolapsed again. Septate hymen and vaginal lumen were also noted. Cystoscopic evaluation showed large left-sided ureterocele prolapsing through the urethra, small right-sided ureterocele and accepted bladder capacity with fine trabeculations. Endoscopic decompression of the left prolapsing ureterocele was performed with diathermy using bugbee electrode in the intravesical part of the ureterocele and bovie electrode in its prolapsing part. The right ureterocele was also decompressed using bugbee electrode.

Endoscopic decompression of the bilateral ureteroceles was successfully achieved and the vulval swelling disappeared, as well. Urethral catheter was kept indwelling for one day, and after removal of the urethral catheter, the patient voided well. Continuous antibiotic prophylaxis was prescribed. The postoperative course was uneventful, as was the follow-up period. During her first follow-up visit after one month, there was no history of febrile urinary tract infection or evidence of vulval swelling by local examination.

Prolapsing ureterocele is an uncommon presentation for ureteroceles in newborn girls, however, it remains one of the common causes of vulval swelling in girls that should not be missed.

Continence 7S1 (2023) 100785
DOI: 10.1016/j.cont.2023.100785